Maculopapular drug eruptions and vasculitis allergica

Maculopapular drug eruption (MDE) or morbilliform exanthema is the most common drug hypersensitivity reaction that affects skin and spare mucous membranes. This pattern of drug reaction is non-specific and may be seen with a wide range of drugs, but most commonly with antibiotics. MDE is clinical diagnosis. Skin of the trunk and limbs is symmetrically affected. In early phase eruption may resembles exanthema caused by viral and bacterial infections or systemic diseases. Morbilliform drug eruption is a non-immediate, type IV hypersensitivity reaction involving drug-specific T cells with direct cytotoxic effects and release of pro-inflammatory cytokins. As these reactions involve many distinct immune mechanisms they may present with different clinical features on skin (maculopapular rashes, erythroderma, exfoliative dermatitis, fixed drug reactions, contact dermatitis) and on oral mucosa (maculopapular enanthema, contact stomatitis, fixed drug eruption, oral lichenoid reaction). It is important, therefore, to understand the complications that medications can have on the oral and general health. In order to properly manage patients, a detailed medication history of all drugs must be taken which will enable to identify the offending drug and its immediate withdrawl from further use.